The fate of inhaled antibiotics after deposition in cystic fibrosis: How to get drug to the bug?
| Autor: | Aukje C. Bos, Kimberly M. Passé, Harm A.W.M. Tiddens, Hettie M. Janssens, Johan W. Mouton |
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| Přispěvatelé: | Pediatrics, Medical Microbiology & Infectious Diseases |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Drug Cystic Fibrosis medicine.drug_class media_common.quotation_subject 030106 microbiology Antibiotics Respiratory Mucosa medicine.disease_cause Cystic fibrosis Microbiology 03 medical and health sciences 0302 clinical medicine Administration Inhalation medicine Humans Tissue Distribution 030212 general & internal medicine Treatment Failure Respiratory Tract Infections media_common Minimum bactericidal concentration Pseudomonas aeruginosa business.industry Chloramphenicol respiratory system medicine.disease Mucus Anti-Bacterial Agents Treatment Outcome lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Pediatrics Perinatology and Child Health Sputum medicine.symptom business medicine.drug |
| Zdroj: | Journal of Cystic Fibrosis, 16, 1, pp. 13-23 Journal of Cystic Fibrosis, 16(1), 13-23. Elsevier Journal of Cystic Fibrosis, 16, 13-23 |
| ISSN: | 1569-1993 |
| Popis: | Background Chronic airway infections in patients with cystic fibrosis (CF) are most often treated with inhaled antibiotics of which deposition patterns have been extensively studied. However, the journey of aerosol particles does not end after deposition within the bronchial tree. Objectives To review how local conditions affect the clinical efficacy of antibiotic aerosol particles after deposition in the airways of patients with CF. Methods Electronic databases were searched from inception to September 2015. Original studies describing the effect of CF sputum or bacterial factors on antibiotic efficacy and formulations to increase efficacy were included. Results 35 articles were included which mostly described in vitro studies and mainly investigated aminoglycosides. After deposition, diffusion through the mucus layer was reduced for aminoglycosides, β-lactam antibiotics and fluoroquinolones. Within CF mucus, low oxygen tension adversely affected aminoglycosides, β-lactam antibiotics, and chloramphenicol; and molecules inactivated aminoglycosides but not β-lactam antibiotics. Finally, the alginate layer surrounding Pseudomonas aeruginosa was an important factor in the resistance against all antibiotics. Conclusions After deposition in the airways, the local efficacy of inhaled antibiotics can be reduced by molecules within CF mucus and the alginate layer surrounding P. aeruginosa . |
| Databáze: | OpenAIRE |
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